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Application for Surrendering Service Tax Registration Certificate

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..... _____ 2. I/ We want to surrender registration for the following reasons. (Specify one of the reason as mentioned at Para 3 of the Trade Notice No. ___________) 3. I/We further declare that we have taken the registration in the year_____. I/We/ Deceased person have paid all service tax dues including the interest or penalty wherever applicable and presently there are no Service Tax dues pending against the registered assessee for which we are making the application for surrender. 4. I/We further declare that we have filed the following returns: Period Return Filed (Yes or No) Date of Filling return Whether manual / electronic We are enclosing copies of St-3 return (maximum of last six returns) 5. We are also enclosing copies of Prof .....

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..... registration mentioned above, we shall pay the service tax dues as and when demanded by the department. 10. We are enclosing print out of online application for surrender duly signed by us along with the copies of ST-3 returns and Profit and Loss account as mentioned above. 11. It is requested to accept application for cancellation of registration in terms of Rule 4 (7) and 4 (8) of Service tax Rules, 1944 as we have complied with the provisions of the said rules. In case any clarification is required, we may be contacted on e-mail address _______________and mobile No. ___________of shri _______________, Designation ________for this purpose. (Signature) Name _________________ (partner /proprietor/ Director/ Other (Specify) Encl: * .....

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..... cases which have been decided and where no appeal has been filed Address of Branches STC No. Order No & Date Issue in brief Amount confirmed (in Rs.) Whether S Tax/ Interest/ Penalty paid, if yes the amount thereof 1 2 3 4 5 6 Whether audit has been conducted by Service Tax/ Central Excise authorities of the concerned Branch. If yes, provide following details: - Address of Branches STC No. Whether audited or not If audited, Period covered in Audit If audited, Audit Report and date (enclose copy 1 2 3 4 5 5. Whether Audit has been conducted by CERA for the Branch ? If Yes, provide following details Branch wise : Address of Branches STC No. Whether audited or not If audited, Period covered in Audit If audited, A .....

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